8.5 Dental Laboratories: Work Orders, Registration, Advertising & Enforcement

Dental Laboratories

Dental laboratories are regulated by the Department, in consultation with the Board, under ss. 466.021 and 466.031–466.039, F.S., and Rule Chapter 64B27, F.A.C. They are the one part of the Board's own study booklet that candidates most often skip — and they carry several crisp, examinable numbers.

What is a dental laboratory — s. 466.031(1)

The term includes any person, firm, or corporation that, for a fee of any kind, gratuitously, or otherwise, directly or through an agent or employee, by any means or method: supplies or manufactures artificial substitutes for natural teeth; furnishes, supplies, constructs, reproduces or repairs any prosthetic denture, bridge, or appliance to be worn in the human mouth; or in any way represents itself as a dental laboratory.

Exclusion: the term does not include a dental laboratory technician who constructs or repairs dental prosthetic appliances in the office of a licensed dentist, exclusively for that dentist, under her or his supervision and work order. The in-office technician is not a separately registrable laboratory.

Section 466.031(2): an employee or independent contractor of a dental laboratory, acting as the laboratory's agent, may engage in onsite consultation with a licensed dentist during a dental procedure.

The dentist's work order — s. 466.021

Each licensed dentist who uses the services of any dental laboratory to construct, alter, repair, or duplicate any denture, implant, veneer, partial denture, bridge splint, orthodontic or other prosthetic appliance, or other suitable form of artificial oral restorative device, shall be required to furnish the dental laboratory with a written prescription in a form prescribed by Board rule.

The prescription must be dated and signed by the dentist and must include:

• The licence number of the dentist;
• The patient's name or number, with sufficient descriptive information to clearly identify each separate and individual piece of work to be performed; and
• A specification of materials to be contained in each work product.

Recall from section 4.1 that s. 466.003(11) provides that issuing a written work authorization to a commercial dental laboratory does not constitute general supervision — the laboratory relationship is not a supervision relationship.

The prescription form — Rule 64B5-17.006

Approved forms must contain all information necessary to complete the assigned work, and at a minimum:

Retention — Rule 64B5-17.006(2): copies must be maintained, on paper or stored electronically in an encrypted database, in the prescribing dentist's office for 4 years following the date the prescription was issued. The original must be retained in a file by the dental laboratory for 4 years.

Lab-to-lab work — Rule 64B5-17.006(3): a registered laboratory may perform work for another registered laboratory only under a written authorisation form titled "Laboratory Procedure Authorization," identifying the originating laboratory and the laboratory performing the work by name, address and licence number, containing evidence that the originating laboratory has obtained a valid prescription (including the name, address and licence number of the dentist who wrote it), and specifying the work and materials.

Presigning is a disciplinary ground. Section 466.028(1)(dd) makes presigning laboratory work order forms a violation — designated a minor violation for an initial offence by Rule 64B5-13.0045(1)(e).

Registration — s. 466.032

Section 466.033: the Department shall not require an examination, but shall issue a registration certificate upon completion of the registration form and compliance with rules adopted under s. 466.038.

Section 466.034: when the ownership or address of any dental laboratory changes, the owner shall notify the Department within 30 days. Rule Chapter 64B27-2 treats failure to notify within 30 days as a citation offence carrying a $100 fine, and provides that closure of the laboratory constitutes a change of address.

Advertising — s. 466.035

"Dental laboratories shall not solicit or advertise, directly or indirectly, by mail, card, newspaper, pamphlet, radio, television, or otherwise to the general public to construct, reproduce, or repair prosthetic dentures, bridges, plates, or other appliances to be used or worn as substitutes for natural teeth or for the regulation of natural teeth."

The prohibition is on advertising to the general public. Laboratories market to dentists; they may not market to patients.

Inspections — s. 466.036

The Department may require any information necessary to carry out the chapter, including proof that the applicant has the equipment and supplies necessary to operate, and shall require periodic inspection of all dental laboratories operating in this state at least once each biennial registration period. Inspections must include, but are not limited to, sanitary conditions, equipment, supplies, and facilities on the premises. The Department shall specify dental equipment and supplies that are not allowed in a registered dental laboratory.

Enforcement — ss. 466.037, 466.038 and 466.039

• Section 466.037: the Department may suspend or revoke the certificate of any registered dental laboratory for failing to comply with the chapter or the Department's rules, and may impose an administrative fine.
• Section 466.038: the Department, upon consultation with the Board of Dentistry and industry representatives of the dental laboratory profession, has authority to adopt rules under ss. 120.536(1) and 120.54 to enforce the laboratory provisions.
• Section 466.039: it is unlawful for any person, firm or corporation to operate as a dental laboratory except those registered under s. 466.032. Violation constitutes a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

Note the grade. Operating an unregistered dental laboratory is a second-degree misdemeanour — the only second-degree misdemeanour in the chapter, and a useful discriminator against the third-degree felonies of s. 466.026(1) and the first-degree misdemeanours of s. 466.026(2).

Rule Chapter 64B27

Related prohibitions elsewhere in the chapter

Section 466.003(3)(b) makes it the practice of dentistry to furnish, supply, construct, reproduce or repair a prosthetic denture, bridge, appliance or other structure to be worn in the mouth except on the written work order of a duly licensed dentist, and s. 466.003(3)(d) reaches delivering such work to any person other than the dentist on whose work order it was performed. A laboratory that delivers a finished appliance directly to a patient is therefore practising dentistry without a licence — a third-degree felony under s. 466.026(1)(a) — quite apart from any registration issue.